ENVIRONMENTAL MANAGEMENT SYSTEM QUESTIONNAIRE (14001:2004)

Please complete this questionnaire and attach any relevant supporting information
describing the Companys scope of operation, e.g. Company brochures or publicity
material.

On receipt of the completed questionnaire, we will prepare and submit our quotation.

1)

Company Name ......

Address .
.....
Telephone . Fax . E-Mail
Contact .
Environmental Representative ..

2)

Is your Company registered against ISO 9001?

YES / NO

If yes, please give:

(a)

the name of the certification body .

(b)

the scope of certification .

.

3)

Please give a list of key processes on site and include a site plan.

Questionnaire

June 05

4)

What is the total number of employees:

Directors / Partners .
Managers .
Staff ..
Workforce ..
Trainees .
Contractors ...
Note: Please advise any shift arrangements.

5)

Has an Initial Review been performed?

YES / NO

If yes, was the expertise provided from: (tick relevant box(es))

(a)

In-house

(b)

Consultancy

(c)

Other, please describe ....

.
.

6)

Are they any activities covered by your scope carried out away from the
registration address(es), e.g. depots, warehouses, sites or offices, which it is
intended to include in the single registration?

YES / NO

If there are, please describe activities,, giving address(es) as appropriate and

staff numbers (Use a separate sheet if necessary).

Questionnaire

June 05

7)

Has an environmental policy been issued and when?

YES / NO

(If yes, please attach)

8)

List significant aspects / effects identical in order of priority.

(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)

9)

List most applicable legislation in order of importance.

(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)

10)

List any licences and authorizations applicable to the facility, i.e. Process
Authorisation, Discharge, Consents, etc.

Questionnaire

June 05

(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
11)

Describe your site by circling as appropriate .. industrial/ urban/ rural/

commercial/ residential.

12)

How is your EMS Documented? (Please attach your contents page)

13)

Have you completed a management review?

YES / NO

14)

Have you completed an Internal Audit?

YES / NO

15)

Implementation date of system .

16)

Is your EMS integrated with:

(a)

Health & Safety

YES / NO

(b)

Quality

YES / NO

Other

17)

Please list any attachments, i.e. Policy, Company Brochures etc.

18)

Is your system paper or electronic based?

.

Comments Section ..

Questionnaire

June 05

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Position in Company

Date ......

Signed

Print Name ...

Questionnaire

June 05